Anatomy

Question 1

List the arterial supply to the upper limb - proximal to distal

Answer 1

Subclavian 
Axillary 
Brachial 
Deep brachial 
Radial and Ulnar 
Deep & superficial palmar arches 
Metacarpal and digital arteries

Question 2

List the arterial supply to the lower limb - proximal to distal

Answer 2

External iliac 
Deep femoral 
Perforating artery 
Femoral artery 
Popliteal artery 
Anterior tibial artery 
Posterior tibial 
Dorsalis pedis 
Medial and lateral plantar 
Arcuate
Metatarsal & digital

Question 3

How can you reduce blood flow to the arm

Answer 3

Put pressure between the subclavian and the first rib

Important in trauma

Question 4

What are end arteries

Answer 4

The only blood supply to an area
Untreated occlusion of these arteries leads to infarction
The digital arteries are end

Question 5

Where is the bifurcation of the common carotid artery

Answer 5

The neck

Anterior to sternocleidomastoid muscle at level of upper border of thyroid cartilage

Question 6

Where does the brachial artery lie

Answer 6

Medial to biceps tendon in the cubital fossa

Question 7

Where does the radial artery lie

Answer 7

Lateral to tendon of flexor carpi radialis

Question 8

Where does the femoral artery lie

Answer 8

Inferior to midpoint of inguinal ligament

Question 9

Where does the popliteal artery lie

Answer 9

In popliteal fossa (immediately posterior to knee joint)

Question 10

Where does the posterior tibial artery lie

Answer 10

Between the posterior border of the medial malleolus & the achilles tendon

Question 11

Where dorsalis pedis artery lie

Answer 11

Medial to tendon of extensor hallucis longus distal to the ankle joint

Question 12

what is ischaemia

Answer 12

inadequate oxygenation of cells/tissues due to an interruption to blood supply

Question 13

What can reduce arterial perfusion pressure

Answer 13

Left ventricular failure
Arterial bleed
Arterial rupture (aneurysm)
Occlusion of lumen 
Arterial spasm
External compression

Question 14

What can increase venous drainage pressure

Answer 14

Right (or congestive) cardiac failure
Deep vein thrombosis (DVT)
External compression

Question 15

What are the features of superficial veins

Answer 15

Smaller, thinner
Run in superficial fascia
Highly variable
Drain into deep veins
More likely to become varicosed

Question 16

What are the features of deep veins

Answer 16

Larger, thicker
Run deep to deep fascia
Lie within muscle compartments 
More predictable
Occur in neurovascular bundles - lie with artery and nerve

Question 17

Describe superficial fascia

Answer 17

Loose connective tissue and fat
Varies in depth
Contains superficial blood vessels, cutaneous nerves, lymphatics and sweat glands

Question 18

Describe deep fascia

Answer 18

Relatively tough and sheet like
Dense connective tissue
Usually white, sometimes glistening appearance
Covers most of the body deep to skin and superficial fascia
Divides limbs into compartments

Question 19

List the deep fascia of the upper limb

Answer 19

Pectoral fascia
Deltoid
Brachial
Antebrachial

Question 20

List the deep fascia of the lower limb

Answer 20

Fascia lata = thigh
Iliotibial tract/band - connects hip to outside of leg
Crural fascia - leg

Question 21

What is the function of deep fascia

Answer 21

Invests muscles
Forms intramuscular septa- compartments
Venous return

Question 22

Describe the path of the cephalic vein

Answer 22

Arises from dorsal venous network
Travels along the lateral aspect of limb
Enters deltopectoral groove
Drains into axillary vein
Becomes subclavian at lateral border of rib 1

Question 23

Describe the path of the basilic vein

Answer 23

Arises from dorsal venous network
Medial aspect of limb
Drains into brachial veins by travelling through the deep fascia (level of mid-arm)

Question 24

Describe the median cubital vein

Answer 24

Connects the cephalic and basilic
Found in the cubital fossa - crook of the elbow
The vein you commonly take blood samples from
Some people have variations where they lack this

Question 25

Describe the path of the great saphenous vein

Answer 25

Arises from dorsal venous arch
Goes from the medial malleolus
Travels up medial aspect of limb
Drains into femoral vein

Question 26

Describe the path of the small saphenous vein

Answer 26

Arises from dorsal venous arch - lateral aspect
Travels up posterior midline of leg
Drains into popliteal vein (posterior to knee)

Question 27

How do you name the deep veins of the limbs

Answer 27

Follow same path and have same names as the arteries

Question 28

What is Vena Comitantes

Answer 28

When veins surround an artery and are enclosed in a vascular sheath
This keeps the vessels close together - tight
As the artery pulsates, it pushes on the veins and helps blood move up through them
Only occurs in smaller veins – brachial and knee downwards

Question 29

What is the function of venous valves

Answer 29

Ensure unidirectional blood flow against gravity

Question 30

What is the musculovenous pump

Answer 30

Blood is pushed back to the heart by skeletal muscle movement when the veins lie in muscular compartments

Question 31

How does blood from superficial veins drain

Answer 31

Normally flows from superficial veins into deep veins through perforating veins

Question 32

What leads to varicose veins and DVT

Answer 32

Immobility and venous valve failure
As you age, the deep fascia becomes less rigid and less effective = increased stasis and increased risk
Perforating veins often become insufficient and lead to more blood in the superficial veins - varicose

Question 33

What causes venous ulceration

Answer 33

Increase in venous pressure damages vessels in the skin
Skin becomes dry, itchy and inflamed but cannot heal well due to poor blood supply
Begins to break down and forms an ulcer
common on medial aspect of lower leg

Question 34

What is a saddle embolus

Answer 34

When a blood clot - often from a DVT blocks the pulmonary trunk
This leads to complete occlusion of the pulmonary system and arrests circulation

Question 35

Describe the lymphatics of the upper limb

Answer 35

Have superficial lymph vessels that follow the cephalic and Basilic veins
Cephalic drains to axillary nodes
Basilic drains to cubital then axillary

There are deep vessels that follow the deep veins and drain to the axillary nodes

Question 36

Describe the lymphatics of the lower limb

Answer 36

the superficial lymph vessels follow the great saphenous veins
The ones following the great s vein drain to superficial inguinal nodes then external iliac or deep inguinal
The ones following the small s vein drain to the popliteal nodes then deep inguinal then external iliac